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World J Gastroenterol. Dec 28, 2006; 12(48): 7805-7809
Published online Dec 28, 2006. doi: 10.3748/wjg.v12.i48.7805
An algorithm for family screening for coeliac disease
Jocelyn S Fraser, Alistair L King, H Julia Ellis, Simon J Moodie, Ingvar Bjarnason, Jill Swift, Paul J Ciclitira
Jocelyn S Fraser, Alistair L King, H Julia Ellis, Simon J Moodie, Ingvar Bjarnason, Jill Swift, Paul J Ciclitira, Division of Nutritional Sciences, King’s College London, United Kingdom
Supported by grants from Coeliac UK and Action Research
Correspondence to: Professor P J Ciclitira, Department of Gastroenterology, The Rayne Institute (KCL), St Thomas’ Hospital, London SE1 7EH, United Kingdom. paul.ciclitira@kcl.ac.uk
Telephone: +44-207-1882494 Fax: +44-207-2610667
Received: August 7, 2006
Revised: August 8, 2006
Accepted: August 29, 2006
Published online: December 28, 2006
Abstract

AIM: To assess the level of undiagnosed coeliac disease (CD) in relatives of patients affected by the condition.

METHODS: We collected blood from 914 relatives of probands. We screened these individuals by ELISA for IgA and IgG tTG antibodies, confirming any positive IgA tTG results with an IgA EMA and looked for evidence of IgA deficiency in those who were IgG tTG positive alone, and performed IgG1 EMA in these individuals. We undertook HLA typing where positive screening was found, and this confirmed a strong prevalence of HLA-DQ2 in the coeliac population. Follow-up small intestinal biopsy was undertaken in cases with positive serological screening, wherever possible.

RESULTS: Use of this serological screening algorithm revealed a prevalence of undiagnosed CD in 5%-6% of first degree relatives of probands.

CONCLUSION: Our data suggests that first degree relatives of individuals with CD should be screened for this condition.

Keywords: Coeliac disease; Screening; Endomysial antibody; Familial study; IgA deficiency; Prevalence; Tissue transglutaminase